造血干细胞移植治疗系统性红斑狼疮的进展

系统性红斑狼疮是一种病因未明的自身免疫性疾病,基本上由自身抗体和免疫复合物介导致病.随着医学在基因水平上不断发展,对于重症SLE不能耐受传统疗法,HSCT目前已是公认的潜在治疗手段之一.从报道HSCT治疗严重AID至今,大约有20个国家的700个患者接受了临床Ⅰ/Ⅱ试验.研究认为,大剂量免疫抑制和移植后免疫重建可能是使SLE缓解的机制.经过10年的临床试验,国内对HSCT治疗手段不断成熟,以北京协和医院为首.虽有明显改善SLE病情,但随诊时期不长,仍存在着许多需要进一步解决的问题,HSCT给予那些难治的其他疗法无效的患者提供了"补救疗法",是否更有效,仍需要进一步进行随机化控制实验.

The advancement of hematopoietic stem cell transplantation for systemic lupus erythematosus

Systemic lupus erythematosus(SLE)is an autoimmune disease,etiopathogenisis unknown,which be resulted in by autoimmune antibody and immune compounds.With medicine upon gene level developing,and refactory SLE failed to daily standard therapies,hematopoietic stem cell transplantation(HSCT)has been accepted as a potential therapeutic tool at present.Since then,about 700 patients from more than 20 countries had received phase Ⅰ/Ⅱ trial of this program.Researchs proposed that immune suppression after excessive dose and restoration of immune disersity may be mechanisms that let active SLE become quiescing.After 10 year's clinical trials,the approach is gradually upgraded,Beijing Xiehe Hospital is a Success example.Although the therapy can improve pathological condition,follow-up period is not long,there are still many problems to be sloved.However,in these studies therapy was given as a "salvage regimen" to patients with lupus who were refractory to multiple therapies.Whether this approach represents a definitive advance over more conventional immunosuppressive therapies needs to be answered in randomized controlled trials.